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Ling Yang - One of the best experts on this subject based on the ideXlab platform.
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fresh Fruit Consumption and all cause and cause specific mortality findings from the china kadoorie biobank
International Journal of Epidemiology, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Robin G Walters, Iona Y MillwoodAbstract:Background Higher Fruit Consumption is associated with lower risk of cardiovascular disease (CVD). Substantial uncertainties remain, however, about the associations of Fruit Consumption with all-cause mortality and mortality from subtypes of CVD and major non-vascular diseases, especially in China. Methods In 2004-08, the nationwide China Kadoorie Biobank Study recruited > 0.5 million adults aged 30-79 years from 10 diverse localities in China. Fresh Fruit Consumption was estimated using an interviewer-administered electronic questionnaire, and mortality data were collected from death registries. Among the 462 342 participants who were free of major chronic diseases at baseline, 17 894 deaths were recorded during ∼ 7 years of follow-up. Cox regression yielded adjusted rate ratios (RRs) for all-cause and cause-specific mortality associated with Fruit Consumption. Results At baseline, 28% of participants reported consuming Fruit ≥ 4 days/week (regular consumers) and 6% reported never/rarely consuming Fruit (non-consumers). Compared with non-consumers, regular consumers had 27% [RR = 0.73, 95% confidence interval (CI) 0.70-0.76] lower all-cause mortality, 34% lower CVD mortality (n = 6166; RR = 0.66, 0.61-0.71), 17% lower cancer mortality (n = 6796; RR = 0.83, 0.78-0.89) and 42% lower mortality from chronic obstructive pulmonary disease (COPD) (n = 1119; RR = 0.58, 0.47-0.71). For each of the above, there was an approximately log-linear dose-response relationship with amount consumed. For mortality from site-specific cancers, Fruit Consumption was inversely associated with digestive tract cancer (n = 2265; RR = 0.72, 0.64-0.81), particularly oesophageal cancer (n = 801; RR = 0.65, 0.50-0.83), but not with cancer of lung or liver. Conclusions Among Chinese adults, higher fresh Fruit Consumption was associated with significantly lower mortality from several major vascular and non-vascular diseases. Given the current low population level of Fruit Consumption, substantial health benefits could be gained from increased Fruit Consumption in China.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications a 7 y prospective study of 0 5 million chinese adults
PLOS Medicine, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Background Despite the well-recognised health benefits of fresh Fruit Consumption, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, on risks of death and major vascular complications. Methods and findings Between June 2004 and July 2008, the nationwide China Kadoorie Biobank study recruited 0.5 million adults aged 30–79 (mean 51) y from ten diverse localities across China. During ~7 y of follow-up, 9,504 new diabetes cases were recorded among 482,591 participants without prevalent (previously diagnosed or screen-detected) diabetes at baseline, with an overall incidence rate of 2.8 per 1,000 person-years. Among 30,300 (5.9%) participants who had diabetes at baseline, 3,389 deaths occurred (overall mortality rate 16.5 per 1,000), along with 9,746 cases of macrovascular disease and 1,345 cases of microvascular disease. Cox regression yielded adjusted hazard ratios (HRs) associating each disease outcome with self-reported fresh Fruit Consumption, adjusting for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, body mass index, and family history of diabetes. Overall, 18.8% of participants reported consuming fresh Fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%). Among those without diabetes at baseline, higher Fruit Consumption was associated with significantly lower risk of developing diabetes (adjusted HR = 0.88 [95% CI 0.83–0.93] for daily versus non-consumers, p < 0.001, corresponding to a 0.2% difference in 5-y absolute risk), with a clear dose–response relationship. Among those with baseline diabetes, higher Fruit Consumption was associated with lower risks of all-cause mortality (adjusted HR = 0.83 [95% CI 0.74–0.93] per 100 g/d) and microvascular (0.72 [0.61–0.87]) and macrovascular (0.87 [0.82–0.93]) complications (p < 0.001), with similar HRs in individuals with previously diagnosed and screen-detected diabetes; estimated differences in 5-y absolute risk between daily and non-consumers were 1.9%, 1.1%, and 5.4%, respectively. The main limitation of this study was that, owing to its observational nature, we could not fully exclude the effects of residual confounding. Conclusion In this large epidemiological study in Chinese adults, higher fresh Fruit Consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications findings from the china kadoorie biobank study
The Lancet Diabetes & Endocrinology, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Abstract Background Although fresh Fruit Consumption has well recognised health benefits, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, the risks of death and vascular complications. We aimed to assess the associations of fresh Fruit Consumption with the risk of incident diabetes and diabetic vascular complications. Methods The China Kadoorie Biobank Study is a prospective cohort study with 512 891 Chinese adults aged 30–79 (mean 51·5, SD 10·7) years recruited from ten diverse localities across China between June 25, 2004, and July 15, 2008. At baseline and during the two subsequent resurveys (conducted from June to October, 2008, and from August, 2013, to September, 2014), data on fresh Fruit Consumption were collected with interviewer-administered electronic questionnaires. Deaths and information on hospital admissions were collected through linkages with death and disease registries and national health insurance claim databases. For each disease endpoint (including incident diabetes and, among baseline diabetics, mortality and hospital admissions of diabetic vascular complications) associated with fresh Fruit Consumption, we used Cox regression analysis to derive adjusted hazards ratios (HRs), adjusting for age, sex, region, education, income, smoking, alcohol Consumption, physical activity, survey season, family history of diabetes, BMI, and Consumption of meat, dairy products, and preserved vegetables. Ethics approval was granted by ethics committees or institutional review boards at the University of Oxford, the Chinese Center for Disease Control and Prevention, the Chinese Academy of Medical Sciences, and all participating regions, and all participants provided written informed consent. Findings During a mean of 7·2 years (SD 1·3) of follow-up, 9504 new diabetes cases were recorded in 482 591 participants without self-reported or screen-detected diabetes at baseline. In 30 300 (5·9%) participants who had diabetes at baseline, 3389 deaths, 9746 macrovascular events requiring hospital admission, and 1345 microvascular events were recorded. 96 586 (18·8%) of all participants reported daily Consumption of fresh Fruit (consumers) and 32 775 (6·4%) never or rarely consumed fresh Fruit (non-consumers). The proportion of non-consumers was about three times higher in participants with baseline self-reported diabetes (17·9% [2893 of 16 162]) than in those with screen-detected diabetes (6·8% [958 of 14 138]) or no diabetes (6·0% [28 924 of 482 591]). In participants without diabetes at baseline, the adjusted HR for incident diabetes was 0·88 (95% CI 0·83–0·93) for daily consumers versus non-consumers, with a clear dose–response relation with the amount consumed. This association was consistent across subgroups of participants at different levels of diabetes risk. In participants with diabetes at baseline, increased fresh Fruit Consumption was associated with reduced risks of death and major vascular diseases, with adjusted HRs per daily portion being 0·83 (0·74–0·93) for all-cause mortality, 0·87 (0·82–0·93) for macrovascular complications, and 0·72 (0·61–0·87) for microvascular complications. The associations were similar in patients with self-reported diabetes and those with screen-detected diabetes, and were not modified by diabetes onset age, duration, or treatment. Interpretation In Chinese adults, higher fresh Fruit Consumption was associated with a significantly lower risk of diabetes and, in those who already had diabetes, lower risks of death, and major vascular complications. Funding Kadoorie Charitable Foundation (Hong Kong, China), UK Wellcome Trust, Chinese National Natural Science Foundation, British Heart Foundation, UK Medical Research Council, and Cancer Research UK.
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fresh Fruit Consumption and major cardiovascular disease in china
The New England Journal of Medicine, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Paul Sherliker, Haiyan Gao, Junshi Chen, Shanqing WangAbstract:BackgroundIn Western populations, a higher level of Fruit Consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the Consumption level is low and rates of stroke are high. MethodsBetween 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh Fruit Consumption to disease rates. ResultsOverall, 18.0% of participants reported consuming fresh Fruit daily. As compared with participants who never or rarely consumed fresh Fruit (the “nonConsumption” category), those who ate fresh frui...
Yiping Chen - One of the best experts on this subject based on the ideXlab platform.
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fresh Fruit Consumption and all cause and cause specific mortality findings from the china kadoorie biobank
International Journal of Epidemiology, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Robin G Walters, Iona Y MillwoodAbstract:Background Higher Fruit Consumption is associated with lower risk of cardiovascular disease (CVD). Substantial uncertainties remain, however, about the associations of Fruit Consumption with all-cause mortality and mortality from subtypes of CVD and major non-vascular diseases, especially in China. Methods In 2004-08, the nationwide China Kadoorie Biobank Study recruited > 0.5 million adults aged 30-79 years from 10 diverse localities in China. Fresh Fruit Consumption was estimated using an interviewer-administered electronic questionnaire, and mortality data were collected from death registries. Among the 462 342 participants who were free of major chronic diseases at baseline, 17 894 deaths were recorded during ∼ 7 years of follow-up. Cox regression yielded adjusted rate ratios (RRs) for all-cause and cause-specific mortality associated with Fruit Consumption. Results At baseline, 28% of participants reported consuming Fruit ≥ 4 days/week (regular consumers) and 6% reported never/rarely consuming Fruit (non-consumers). Compared with non-consumers, regular consumers had 27% [RR = 0.73, 95% confidence interval (CI) 0.70-0.76] lower all-cause mortality, 34% lower CVD mortality (n = 6166; RR = 0.66, 0.61-0.71), 17% lower cancer mortality (n = 6796; RR = 0.83, 0.78-0.89) and 42% lower mortality from chronic obstructive pulmonary disease (COPD) (n = 1119; RR = 0.58, 0.47-0.71). For each of the above, there was an approximately log-linear dose-response relationship with amount consumed. For mortality from site-specific cancers, Fruit Consumption was inversely associated with digestive tract cancer (n = 2265; RR = 0.72, 0.64-0.81), particularly oesophageal cancer (n = 801; RR = 0.65, 0.50-0.83), but not with cancer of lung or liver. Conclusions Among Chinese adults, higher fresh Fruit Consumption was associated with significantly lower mortality from several major vascular and non-vascular diseases. Given the current low population level of Fruit Consumption, substantial health benefits could be gained from increased Fruit Consumption in China.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications a 7 y prospective study of 0 5 million chinese adults
PLOS Medicine, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Background Despite the well-recognised health benefits of fresh Fruit Consumption, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, on risks of death and major vascular complications. Methods and findings Between June 2004 and July 2008, the nationwide China Kadoorie Biobank study recruited 0.5 million adults aged 30–79 (mean 51) y from ten diverse localities across China. During ~7 y of follow-up, 9,504 new diabetes cases were recorded among 482,591 participants without prevalent (previously diagnosed or screen-detected) diabetes at baseline, with an overall incidence rate of 2.8 per 1,000 person-years. Among 30,300 (5.9%) participants who had diabetes at baseline, 3,389 deaths occurred (overall mortality rate 16.5 per 1,000), along with 9,746 cases of macrovascular disease and 1,345 cases of microvascular disease. Cox regression yielded adjusted hazard ratios (HRs) associating each disease outcome with self-reported fresh Fruit Consumption, adjusting for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, body mass index, and family history of diabetes. Overall, 18.8% of participants reported consuming fresh Fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%). Among those without diabetes at baseline, higher Fruit Consumption was associated with significantly lower risk of developing diabetes (adjusted HR = 0.88 [95% CI 0.83–0.93] for daily versus non-consumers, p < 0.001, corresponding to a 0.2% difference in 5-y absolute risk), with a clear dose–response relationship. Among those with baseline diabetes, higher Fruit Consumption was associated with lower risks of all-cause mortality (adjusted HR = 0.83 [95% CI 0.74–0.93] per 100 g/d) and microvascular (0.72 [0.61–0.87]) and macrovascular (0.87 [0.82–0.93]) complications (p < 0.001), with similar HRs in individuals with previously diagnosed and screen-detected diabetes; estimated differences in 5-y absolute risk between daily and non-consumers were 1.9%, 1.1%, and 5.4%, respectively. The main limitation of this study was that, owing to its observational nature, we could not fully exclude the effects of residual confounding. Conclusion In this large epidemiological study in Chinese adults, higher fresh Fruit Consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications findings from the china kadoorie biobank study
The Lancet Diabetes & Endocrinology, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Abstract Background Although fresh Fruit Consumption has well recognised health benefits, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, the risks of death and vascular complications. We aimed to assess the associations of fresh Fruit Consumption with the risk of incident diabetes and diabetic vascular complications. Methods The China Kadoorie Biobank Study is a prospective cohort study with 512 891 Chinese adults aged 30–79 (mean 51·5, SD 10·7) years recruited from ten diverse localities across China between June 25, 2004, and July 15, 2008. At baseline and during the two subsequent resurveys (conducted from June to October, 2008, and from August, 2013, to September, 2014), data on fresh Fruit Consumption were collected with interviewer-administered electronic questionnaires. Deaths and information on hospital admissions were collected through linkages with death and disease registries and national health insurance claim databases. For each disease endpoint (including incident diabetes and, among baseline diabetics, mortality and hospital admissions of diabetic vascular complications) associated with fresh Fruit Consumption, we used Cox regression analysis to derive adjusted hazards ratios (HRs), adjusting for age, sex, region, education, income, smoking, alcohol Consumption, physical activity, survey season, family history of diabetes, BMI, and Consumption of meat, dairy products, and preserved vegetables. Ethics approval was granted by ethics committees or institutional review boards at the University of Oxford, the Chinese Center for Disease Control and Prevention, the Chinese Academy of Medical Sciences, and all participating regions, and all participants provided written informed consent. Findings During a mean of 7·2 years (SD 1·3) of follow-up, 9504 new diabetes cases were recorded in 482 591 participants without self-reported or screen-detected diabetes at baseline. In 30 300 (5·9%) participants who had diabetes at baseline, 3389 deaths, 9746 macrovascular events requiring hospital admission, and 1345 microvascular events were recorded. 96 586 (18·8%) of all participants reported daily Consumption of fresh Fruit (consumers) and 32 775 (6·4%) never or rarely consumed fresh Fruit (non-consumers). The proportion of non-consumers was about three times higher in participants with baseline self-reported diabetes (17·9% [2893 of 16 162]) than in those with screen-detected diabetes (6·8% [958 of 14 138]) or no diabetes (6·0% [28 924 of 482 591]). In participants without diabetes at baseline, the adjusted HR for incident diabetes was 0·88 (95% CI 0·83–0·93) for daily consumers versus non-consumers, with a clear dose–response relation with the amount consumed. This association was consistent across subgroups of participants at different levels of diabetes risk. In participants with diabetes at baseline, increased fresh Fruit Consumption was associated with reduced risks of death and major vascular diseases, with adjusted HRs per daily portion being 0·83 (0·74–0·93) for all-cause mortality, 0·87 (0·82–0·93) for macrovascular complications, and 0·72 (0·61–0·87) for microvascular complications. The associations were similar in patients with self-reported diabetes and those with screen-detected diabetes, and were not modified by diabetes onset age, duration, or treatment. Interpretation In Chinese adults, higher fresh Fruit Consumption was associated with a significantly lower risk of diabetes and, in those who already had diabetes, lower risks of death, and major vascular complications. Funding Kadoorie Charitable Foundation (Hong Kong, China), UK Wellcome Trust, Chinese National Natural Science Foundation, British Heart Foundation, UK Medical Research Council, and Cancer Research UK.
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fresh Fruit Consumption and major cardiovascular disease in china
The New England Journal of Medicine, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Paul Sherliker, Haiyan Gao, Junshi Chen, Shanqing WangAbstract:BackgroundIn Western populations, a higher level of Fruit Consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the Consumption level is low and rates of stroke are high. MethodsBetween 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh Fruit Consumption to disease rates. ResultsOverall, 18.0% of participants reported consuming fresh Fruit daily. As compared with participants who never or rarely consumed fresh Fruit (the “nonConsumption” category), those who ate fresh frui...
Laure Dossus - One of the best experts on this subject based on the ideXlab platform.
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vegetable and Fruit Consumption and the risk of hormone receptor defined breast cancer in the epic cohort
The American Journal of Clinical Nutrition, 2016Co-Authors: Marleen J Emaus, Petra H M Peeters, Marije F Bakker, Kim Overvad, Anne Tjonneland, Anja Olsen, Isabelle Romieu, Pietro Ferrari, Laure DossusAbstract:Background: The recent literature indicates that a high vegetable intake and not a high Fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk.Objective: This study aimed to investigate the association between vegetable and Fruit intake and steroid hormone receptor–defined breast cancer risk.Design: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and Fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.Results: After a median follow-up of 11.5 y (IQR: 10.1–12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER−PR−)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5–quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER−PR− breast cancer (ER−PR−: HRquintile 5–quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5–quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor–defined breast cancer risk.Conclusion: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor–negative) breast cancer risk.
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vegetable and Fruit Consumption and the risk of hormone receptor defined breast cancer in the epic cohort
The American Journal of Clinical Nutrition, 2016Co-Authors: Marleen J Emaus, Petra H M Peeters, Marije F Bakker, Kim Overvad, Anne Tjonneland, Anja Olsen, Isabelle Romieu, Pietro Ferrari, Laure DossusAbstract:Background: The recent literature indicates that a high vegetable intake and not a high Fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk.Objectiv ...
Petra H M Peeters - One of the best experts on this subject based on the ideXlab platform.
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vegetable and Fruit Consumption and the risk of hormone receptor defined breast cancer in the epic cohort
The American Journal of Clinical Nutrition, 2016Co-Authors: Marleen J Emaus, Petra H M Peeters, Marije F Bakker, Kim Overvad, Anne Tjonneland, Anja Olsen, Isabelle Romieu, Pietro Ferrari, Laure DossusAbstract:Background: The recent literature indicates that a high vegetable intake and not a high Fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk.Objective: This study aimed to investigate the association between vegetable and Fruit intake and steroid hormone receptor–defined breast cancer risk.Design: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and Fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.Results: After a median follow-up of 11.5 y (IQR: 10.1–12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER−PR−)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5–quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER−PR− breast cancer (ER−PR−: HRquintile 5–quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5–quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor–defined breast cancer risk.Conclusion: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor–negative) breast cancer risk.
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vegetable and Fruit Consumption and the risk of hormone receptor defined breast cancer in the epic cohort
The American Journal of Clinical Nutrition, 2016Co-Authors: Marleen J Emaus, Petra H M Peeters, Marije F Bakker, Kim Overvad, Anne Tjonneland, Anja Olsen, Isabelle Romieu, Pietro Ferrari, Laure DossusAbstract:Background: The recent literature indicates that a high vegetable intake and not a high Fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk.Objectiv ...
Derrick A Bennett - One of the best experts on this subject based on the ideXlab platform.
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fresh Fruit Consumption and all cause and cause specific mortality findings from the china kadoorie biobank
International Journal of Epidemiology, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Robin G Walters, Iona Y MillwoodAbstract:Background Higher Fruit Consumption is associated with lower risk of cardiovascular disease (CVD). Substantial uncertainties remain, however, about the associations of Fruit Consumption with all-cause mortality and mortality from subtypes of CVD and major non-vascular diseases, especially in China. Methods In 2004-08, the nationwide China Kadoorie Biobank Study recruited > 0.5 million adults aged 30-79 years from 10 diverse localities in China. Fresh Fruit Consumption was estimated using an interviewer-administered electronic questionnaire, and mortality data were collected from death registries. Among the 462 342 participants who were free of major chronic diseases at baseline, 17 894 deaths were recorded during ∼ 7 years of follow-up. Cox regression yielded adjusted rate ratios (RRs) for all-cause and cause-specific mortality associated with Fruit Consumption. Results At baseline, 28% of participants reported consuming Fruit ≥ 4 days/week (regular consumers) and 6% reported never/rarely consuming Fruit (non-consumers). Compared with non-consumers, regular consumers had 27% [RR = 0.73, 95% confidence interval (CI) 0.70-0.76] lower all-cause mortality, 34% lower CVD mortality (n = 6166; RR = 0.66, 0.61-0.71), 17% lower cancer mortality (n = 6796; RR = 0.83, 0.78-0.89) and 42% lower mortality from chronic obstructive pulmonary disease (COPD) (n = 1119; RR = 0.58, 0.47-0.71). For each of the above, there was an approximately log-linear dose-response relationship with amount consumed. For mortality from site-specific cancers, Fruit Consumption was inversely associated with digestive tract cancer (n = 2265; RR = 0.72, 0.64-0.81), particularly oesophageal cancer (n = 801; RR = 0.65, 0.50-0.83), but not with cancer of lung or liver. Conclusions Among Chinese adults, higher fresh Fruit Consumption was associated with significantly lower mortality from several major vascular and non-vascular diseases. Given the current low population level of Fruit Consumption, substantial health benefits could be gained from increased Fruit Consumption in China.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications a 7 y prospective study of 0 5 million chinese adults
PLOS Medicine, 2017Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Background Despite the well-recognised health benefits of fresh Fruit Consumption, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, on risks of death and major vascular complications. Methods and findings Between June 2004 and July 2008, the nationwide China Kadoorie Biobank study recruited 0.5 million adults aged 30–79 (mean 51) y from ten diverse localities across China. During ~7 y of follow-up, 9,504 new diabetes cases were recorded among 482,591 participants without prevalent (previously diagnosed or screen-detected) diabetes at baseline, with an overall incidence rate of 2.8 per 1,000 person-years. Among 30,300 (5.9%) participants who had diabetes at baseline, 3,389 deaths occurred (overall mortality rate 16.5 per 1,000), along with 9,746 cases of macrovascular disease and 1,345 cases of microvascular disease. Cox regression yielded adjusted hazard ratios (HRs) associating each disease outcome with self-reported fresh Fruit Consumption, adjusting for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, body mass index, and family history of diabetes. Overall, 18.8% of participants reported consuming fresh Fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%). Among those without diabetes at baseline, higher Fruit Consumption was associated with significantly lower risk of developing diabetes (adjusted HR = 0.88 [95% CI 0.83–0.93] for daily versus non-consumers, p < 0.001, corresponding to a 0.2% difference in 5-y absolute risk), with a clear dose–response relationship. Among those with baseline diabetes, higher Fruit Consumption was associated with lower risks of all-cause mortality (adjusted HR = 0.83 [95% CI 0.74–0.93] per 100 g/d) and microvascular (0.72 [0.61–0.87]) and macrovascular (0.87 [0.82–0.93]) complications (p < 0.001), with similar HRs in individuals with previously diagnosed and screen-detected diabetes; estimated differences in 5-y absolute risk between daily and non-consumers were 1.9%, 1.1%, and 5.4%, respectively. The main limitation of this study was that, owing to its observational nature, we could not fully exclude the effects of residual confounding. Conclusion In this large epidemiological study in Chinese adults, higher fresh Fruit Consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.
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fresh Fruit Consumption in relation to incident diabetes and diabetic vascular complications findings from the china kadoorie biobank study
The Lancet Diabetes & Endocrinology, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Zheng Bian, Yiping Chen, Iain Turnbull, Fiona Bragg, Junshi ChenAbstract:Abstract Background Although fresh Fruit Consumption has well recognised health benefits, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, the risks of death and vascular complications. We aimed to assess the associations of fresh Fruit Consumption with the risk of incident diabetes and diabetic vascular complications. Methods The China Kadoorie Biobank Study is a prospective cohort study with 512 891 Chinese adults aged 30–79 (mean 51·5, SD 10·7) years recruited from ten diverse localities across China between June 25, 2004, and July 15, 2008. At baseline and during the two subsequent resurveys (conducted from June to October, 2008, and from August, 2013, to September, 2014), data on fresh Fruit Consumption were collected with interviewer-administered electronic questionnaires. Deaths and information on hospital admissions were collected through linkages with death and disease registries and national health insurance claim databases. For each disease endpoint (including incident diabetes and, among baseline diabetics, mortality and hospital admissions of diabetic vascular complications) associated with fresh Fruit Consumption, we used Cox regression analysis to derive adjusted hazards ratios (HRs), adjusting for age, sex, region, education, income, smoking, alcohol Consumption, physical activity, survey season, family history of diabetes, BMI, and Consumption of meat, dairy products, and preserved vegetables. Ethics approval was granted by ethics committees or institutional review boards at the University of Oxford, the Chinese Center for Disease Control and Prevention, the Chinese Academy of Medical Sciences, and all participating regions, and all participants provided written informed consent. Findings During a mean of 7·2 years (SD 1·3) of follow-up, 9504 new diabetes cases were recorded in 482 591 participants without self-reported or screen-detected diabetes at baseline. In 30 300 (5·9%) participants who had diabetes at baseline, 3389 deaths, 9746 macrovascular events requiring hospital admission, and 1345 microvascular events were recorded. 96 586 (18·8%) of all participants reported daily Consumption of fresh Fruit (consumers) and 32 775 (6·4%) never or rarely consumed fresh Fruit (non-consumers). The proportion of non-consumers was about three times higher in participants with baseline self-reported diabetes (17·9% [2893 of 16 162]) than in those with screen-detected diabetes (6·8% [958 of 14 138]) or no diabetes (6·0% [28 924 of 482 591]). In participants without diabetes at baseline, the adjusted HR for incident diabetes was 0·88 (95% CI 0·83–0·93) for daily consumers versus non-consumers, with a clear dose–response relation with the amount consumed. This association was consistent across subgroups of participants at different levels of diabetes risk. In participants with diabetes at baseline, increased fresh Fruit Consumption was associated with reduced risks of death and major vascular diseases, with adjusted HRs per daily portion being 0·83 (0·74–0·93) for all-cause mortality, 0·87 (0·82–0·93) for macrovascular complications, and 0·72 (0·61–0·87) for microvascular complications. The associations were similar in patients with self-reported diabetes and those with screen-detected diabetes, and were not modified by diabetes onset age, duration, or treatment. Interpretation In Chinese adults, higher fresh Fruit Consumption was associated with a significantly lower risk of diabetes and, in those who already had diabetes, lower risks of death, and major vascular complications. Funding Kadoorie Charitable Foundation (Hong Kong, China), UK Wellcome Trust, Chinese National Natural Science Foundation, British Heart Foundation, UK Medical Research Council, and Cancer Research UK.
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fresh Fruit Consumption and major cardiovascular disease in china
The New England Journal of Medicine, 2016Co-Authors: Derrick A Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Paul Sherliker, Haiyan Gao, Junshi Chen, Shanqing WangAbstract:BackgroundIn Western populations, a higher level of Fruit Consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the Consumption level is low and rates of stroke are high. MethodsBetween 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh Fruit Consumption to disease rates. ResultsOverall, 18.0% of participants reported consuming fresh Fruit daily. As compared with participants who never or rarely consumed fresh Fruit (the “nonConsumption” category), those who ate fresh frui...
